They a mighty little Australians; born extremely premature, they had the odds stacked against them, some were born so early they were in the grey zone of viability.

Advances in medical expertise and technology means these babies now have a good chance of survival but they still face an obstacle course of infections, surgeries, brain bleeds, bowel complications, breathing and feeding issues.

But they have come out the other side and look at them now.

AUBREE BILLINGHURST

Born: August 25 at 24 weeks

Meghan Billinghurst was just 23 weeks pregnant when her cervix started dilating - 17 weeks early. Her unborn baby was in what is termed "the grey zone" and had only a 9 per cent chance of survival without a severe disability.

Three-quarters of babies born at 23 weeks die. If she could get to 24 weeks, at least the baby had a coin-flip chance of survival.

Aubree Billinghurst was born at 24 weeks and weighed 660 grams.
Aubree Billinghurst was born at 24 weeks and weighed 660 grams.

In the birthing unit at Liverpool hospital, the 26-year-old first time mum and her husband Jake were faced with a terrifying choice.

"When we arrived the neonatologist came in and told us the worst that can happen and it was just horrible," she said.

"We were given three options - natural birth with no resuscitation and cuddle until the baby passes away, or natural birth with resuscitation, which has risks, or caesarean and do everything you can."

Her baby was in the breech position as well, making a natural birth very risky.

"We chose natural birth with resuscitation to see how long we could hold on for," she said.

"If we chose caesarean they would have taken me in there and then and she would have been 23 weeks. My thought was, if we can keep her in a bit longer, let her grow a bit more inside, then that is what we will do."

Aubree needed breathing support with CPAP but she wasn’t always happy about it.
Aubree needed breathing support with CPAP but she wasn’t always happy about it.

Meghan spent the next 11 days in and out of labour.

"I had a massive bleed and contractions that were painful over 11 days, but I wasn't in active labour until the night of her birth on the 25th of August," she said.

"I was 24 weeks and six days. I was able to get two rounds of steroids for her lungs and a magnesium drip, which is believed to help brain development."

Rushed in for an emergency caesarean, Aubree came into the world weighing a tiny 660 grams. Most babies born at this time need to be resuscitated because their lungs are not ready for oxygen, they collapse on themselves once delivered. But Aubree was something else.

She started screaming her tiny little head off.

"She weighed 660 grams, so she came out screaming and had an APGAR (baby health check) of eight, which was pretty amazing for her gestation."

The APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) test has a maximum score of 10 and anything above seven is considered normal.

Clearly Aubree was not going to let being almost four months early get in her way.

But her mum had to watch her tiny baby clinging to life in the closest made-made version of a womb - a humidicrib with the humidity turned up to 85 per cent. The skin of babies born this early is not yet fully formed and they can literally leak out, hence the humidity required.

"I was wheeled into a place full of sick babies, then seeing her was terrifying and reassuring at the same time. She looked like a red jelly bean and her skin was translucent," she said.

Aubree Billinghurst spent 118 days in hospital before going home.
Aubree Billinghurst spent 118 days in hospital before going home.

Because Aubree could breathe on her own without a ventilator, Meghan could actually hold her darling baby.

"I felt trepidation, she was so little I didn't want to hurt her, she felt like nothing," she said.

Aubree had a remarkable run for a baby born so early. She needed CPAP (continuous positive air pressure) support to help her breathe but at 32 weeks, she hit a serious hurdle. Necrotising enterocolitis, where part of the bowel dies, is a common complication in premature babies.

"She had a complete bowel obstruction caused by NEC and we were emergency transferred to Royal Women's at Randwick. She had to have surgery and have a laparotomy where they removed the bowel obstruction. And she came out of surgery and she hasn't looked back from there," she said.

After 118 days in hospital, Aubree got to go to her home near Camden just before Christmas weighing 2.8 kilograms. Because of COVID restrictions in hospital, her grandparents on both sides had never met her.

"She is the first grandbaby and no grandparents got to meet her for 118 days, so Christmas was amazing seeing everyone loving on her," she said.

Now six months old, she is a happy, thriving baby.

"She is an absolute miracle, she is kicking all of her goals, she is feisty, she is sassy and she has such a good personality. She is just amazing," Meghan said.

"We are so grateful for the doctors and nurses and technology we have had, because without that technology she wouldn't be here."

ANGUS AND CHARLIE MCGUINESS

Born: April 11, 2020 at 26 weeks

At nine months of age, Angus and Charlie are adorable, smiling twins. You would never know they came into the world 14 weeks early.

Bronwyn McGuiness, 34, from Lugarno was having a dream first pregnancy until her waters broke 26 weeks into her pregnancy.

"The next minute we were told the boys will be born in the next 10 hours or so. That night they were born at 26 weeks and we spent the next three months in hospital," dad Mitch McGuiness said.

The statistics for "26 weekers" are confronting. They have a 14 per cent change of dying, 18 per cent change of mild disability, 11 per cent chance of severe disability and only a 57 per chance of developing normally. Girls do better than boys, singletons do better than twins.

Charlie McGuiness shortly after his birth in April. He weighed 1116 grams.
Charlie McGuiness shortly after his birth in April. He weighed 1116 grams.

Four hours after their birth at Royal North Shore Hospital, Bronwyn got to meet her babies. But as both were intubated, their parents would have to wait some days before they could hold them.

Angus McGuiness shortly after his birth in April. He weighed 1020 grams.
Angus McGuiness shortly after his birth in April. He weighed 1020 grams.

"They were just the tiniest, smallest babies I've seen, all connected to tubes," she said.

"They were translucent and swollen and bruised, but then they wrapped their little finger around mine and I was overwhelmed. I was in awe but I was petrified about what could happen."

Premature twins Angus and Charlie McGuiness at home. Picture: Tim Hunter
Premature twins Angus and Charlie McGuiness at home. Picture: Tim Hunter

The blood vessels in the brains of many micro-premmies bleed because they are underdeveloped.

"The boys both had blood transfusions and bleeding on the brain, which is quite scary but quite normal for that kind of territory and they have come out the other side, they are little fighters, that's for sure," Mitch said.

"I can't speak higher of the every single doctor and nurse and neonatologist that took care of our boys, they are the reason these boys are here today," Bronwyn said.

"They are absolute angels, the work they do right smack-bang in the middle of COVID. It was three months before they could have a cuddle with their grandparents."

 

The twins with their mum Bronwyn McGuiness. Picture: Tim Hunter
The twins with their mum Bronwyn McGuiness. Picture: Tim Hunter

The boys came home after 12 weeks in hospital.

"We were really, really lucky. We held our breath for about 12 weeks I think," Bronwyn said.

"They are little ratbags, rolling and smiling and thriving is the best way to describe them. They are still little for their gestational age, but they are hitting milestones and are delightful."

 

SCOUT GIRLING

Born: February 2, 2020 at 25 weeks

Scout Girling was due on June 3 but she was born 15 weeks early in February.

Her mum Bethany had a history of giving birth early - her three siblings were born between 31 and 35 weeks - but a "25 weeker" was a different ball game.

"At 25 weeks my waters ruptured and I went in to hospital and was put on antibiotics but under 48 hours later I started getting fevers and going into labour and I had an infection in my uterus last pregnancy so they were worried I was getting that so they decided to do an emergency caesarean at Westmead Hospital."

Scout Girling at birth. She weighed 900 grams and needed a ventilator to breathe. Picture: Supplied
Scout Girling at birth. She weighed 900 grams and needed a ventilator to breathe. Picture: Supplied

With her husband Tim, Scout was the eighth child in their blended family but they did not know if she was going to make it. Weighing only 900 grams, she was in for a fight.

"She was so tiny and sick. The doctor said there was a 20 to 25 per cent chance she would die, so that wasn't pleasant to hear," the Toongabbie mum said.

"It was overwhelming. I didn't expect her to be so tiny, it was pretty scary and I was in shock. Her skin was almost see-through, her eyes were still fused shut and she was hooked up to all the breathing equipment. She was in a humidicrib, which was really hot and humid and sticky."

As their skin is not yet developed for the outside world, the humidicrib controls the moist environment to allow the skin to mature.

"She came out dead silent and I freaked out but she was breathing, she was just quiet, she is just a calm baby, she has a really placid nature," she said.

Bethany Girling with her daughter Scout. Picture: Sam Ruttyn
Bethany Girling with her daughter Scout. Picture: Sam Ruttyn

Scout's biggest hurdle was her heart. The patent ductus arteriosus or PDA would not close and was forcing blood into her lungs.

"That was her biggest hurdle. It kept reopening and they would close it with medication and then it would open again," she said.

"So around three or four weeks in she was really sick, that was the only time we thought we might lose her. It was causing blood to go the wrong way and filling her lungs with blood, they scheduled her in for surgery but just before she picked up and the cardiologist decided not to do the surgery and there from there she picked up and got better every day.

"COVID was a blessing in disguise because my husband was working from home.

"(But) it was hard, he could not come in, we only could have one parent at a time, so he did not see her much at all, which was hard for him."

Scout Girling at 11 months of age. Image supplied by the family.,
Scout Girling at 11 months of age. Image supplied by the family.,

After 12 weeks in hospital, Scout, weighing 2.1 kilograms, got to go home in May to join her seven other siblings aged 14 to three. She turns one next month.

"She has the most beautiful temperament, she is a placid little girl, she is smiley and happy to go to anyone," Bethany said.

"Nature-wise she is the best baby I've had, she sleeps well at night, which is amazing after everything she has gone through - she just takes it in her stride."

 

SKYLAH AUSTIN

Born: February 23, 2019 at 24 weeks

The Sunday Telegraph first met Skylah in 2019 because she was one of the tiniest babies in NSW to ever survive. Born at exactly 24 weeks, she weighed just 475 grams. Babies under 500 grams rarely survive.

Skylah Austin was born at 24 weeks, weighing just 475 grams.
Skylah Austin was born at 24 weeks, weighing just 475 grams.

Hollee Austin, 36, literally put her life on the line to get Skylah to 24 weeks after pre-eclampsia almost claimed both their lives.

"At exactly 24 weeks they said we can't wait anymore, it was my life otherwise, but I held on for her and wasn't going to give up," Hollee said.

One week into her precarious life, part of Skylah's bowel started to die. She needed surgery but the tiny baby was too sick to be moved, so the theatre came to her.

Skylah Austin had a long journey, spending almost five months in hospital.
Skylah Austin had a long journey, spending almost five months in hospital.

Skylah pulled through and, after four weeks of life, Hollee got her first cuddle. It's known as kangaroo care, a skin-to-skin cuddle for baby and parent.

Skylah Austin is now thriving after being born premature.
Skylah Austin is now thriving after being born premature.

After five months in hospital, Hollee and dad Peter took their baby home to Camden but COVID has changed things dramatically for the family. Skylah's dad is a fly-in, fly-out worker with the mines in Queensland and got stuck in Emerald when the borders closed last year. Now they have all moved to Airlie Beach to keep the family together.

Skylah turns two next month and look at her now.

"She walking and eating normally now, she was tube-fed for a long time, but she's eating perfectly now," she said.

"We have to watch her development. She is still quite little and weighs 8.5kg, but she was one of the smallest in Australia and that is a huge accomplishment for all of the medical team."

Originally published as Miracle babies: Premmies who beat the odds

Meghan and Jake Billinghurst with Aubree at home. Picture: Sam Ruttyn
Meghan and Jake Billinghurst with Aubree at home. Picture: Sam Ruttyn


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